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1.
Nutr Clin Pract ; 35(2): 323-330, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31606911

RESUMEN

BACKGROUND: Many health benefits have been proposed for citrulline, but they lack evidence based on human research. This study was to evaluate whether an oral citrulline supplement affects body weight changes and laboratory values in patients with hepatobiliary and pancreatic surgery. METHODS: Patients who underwent hepatobiliary and pancreatic surgery during January to June 2015 were screened for analysis. Patients using citrulline during hospital stay and at discharge were classified as the citrulline group, whereas those without any records of citrulline were designated as the control group. The primary efficacy outcome was the change in body weight at discharge and at first outpatient visit. Other outcomes included change in laboratory values. RESULTS: A total of 138 patients were included in analysis. Citrulline group and control group did not differ with respect to baseline characteristics except for white blood cell count. Percent in change of body weight and body mass index from discharge to first outpatient visit was significantly different between the 2 groups, showing less weight loss in citrulline group than in controls (-0.8 ± 2.7% vs -2.5 ± 3.8%, P < 0.05). Especially in men, citrulline use significantly affected weight loss from the multivariate analysis (P < 0.05); percent change in weight in citrulline group was predicted to increase by 2.1 units. During hospital stay, significant differences between the 2 groups were found in changes of cholesterol and protein levels. CONCLUSION: Citrulline supplement reduced weight loss in surgical patients during recovery.


Asunto(s)
Peso Corporal/efectos de los fármacos , Citrulina/uso terapéutico , Suplementos Dietéticos , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Humanos , Tiempo de Internación , Hepatopatías/cirugía , Masculino , Persona de Mediana Edad , Análisis Multivariante , Enfermedades Pancreáticas/cirugía , Nutrición Parenteral , Complicaciones Posoperatorias/terapia , Resultado del Tratamiento , Pérdida de Peso/efectos de los fármacos , Adulto Joven
2.
Am J Health Syst Pharm ; 74(12): 904-918, 2017 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-28596227

RESUMEN

PURPOSE: Results of a meta-analysis of data from clinical studies comparing patient outcomes and hospital length of stay (LOS) in surgical patients receiving fish oil (FO)-containing i.v. fat emulsions (IVFEs) versus non-FO-containing IVFEs are presented. METHODS: Computerized searches of the MEDLINE, Embase, and Coch rane CENTRAL databases were performed in August 2014 to identify English-language articles on randomized controlled trials (RCTs) comparing FO-containing and non-FO-containing IVFEs in adult surgical patients receiving parenteral nutrition. Selected articles were analyzed for methodological and publication bias and study heterogeneity (I2 statistic). RESULTS: Data from 19 RCTs (total n = 1,167) were included in the meta-analysis. Compared with use of non-FO-containing IVFEs (products based in soybean oil [SO], medium-chain triglycerides, or olive oil), use of FO-containing IVFEs was associated with reduced infectious morbidity (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.30-0.65; p < 0.0001; I2 = 0%); the effect size was greatest for FO-containing versus SO-based IVFEs. Relative to use of SO-based IVFEs, use of FO-containing IVFEs was associated with a significant reduction in hospital LOS (weighted mean difference, -2.70 days; 95% CI, -3.60 to -1.79 days; p < 0.00001; I2 = 0%). CONCLUSION: The results of the meta-analysis indicated that FO-containing IVFEs could improve infectious morbidity and LOS. The overall effect of reducing infectious morbidity and LOS was found to be the greatest in comparison with the SO-based IVFEs.


Asunto(s)
Emulsiones Grasas Intravenosas/administración & dosificación , Ácidos Grasos Omega-3/administración & dosificación , Atención Perioperativa/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Humanos , Tiempo de Internación/tendencias , Atención Perioperativa/tendencias , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Resultado del Tratamiento
3.
Int J Pharm ; 456(2): 432-6, 2013 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-24008082

RESUMEN

This study aims to investigate the feasibility of Levodopa transdermal delivery systems (TDSs). Levodopa TDSs were formulated using various vehicles and permeation enhancers, and in vitro permeation and in vivo pharmacokinetic studies were carried out. In the in vitro study, ester-type vehicles showed relatively high enhancing effects; propylene glycol monocaprylate and propylene glycol monolaurate showed the highest permeation fluxes from both solution and pressure sensitive adhesive (PSA) TDS formulations. Lag time was dramatically shortened with PSA TDS formulations as compared with solution formulations. In the in vivo study, the addition of fatty acids increased blood drug concentrations regardless of the kind or concentration of fatty acid; the AUCinf increased up to 8.7 times as compared with propylene glycol (PG) alone. PSA TDS containing 10% linoleic acid exhibited prolonged Tmax as compared with oral form. Total clearance of L-dopa from PSA TDSs was significantly lower than from oral form (up to 86.8 times). Especially, PSA TDS containing 10% linoleic acid (LOA) revealed 76.2 fold higher AUCinf than oral administration. Based on our results, the L-dopa PSA TDS containing PG with 10% LOA could be used as a good adjuvant therapy for Parkinson's disease patients who experience symptom fluctuation by L-dopa oral administration.


Asunto(s)
Sistemas de Liberación de Medicamentos/métodos , Levodopa/administración & dosificación , Levodopa/química , Absorción Cutánea/efectos de los fármacos , Administración Cutánea , Animales , Química Farmacéutica , Evaluación Preclínica de Medicamentos/métodos , Humanos , Levodopa/sangre , Masculino , Ratones , Ratones Pelados , Técnicas de Cultivo de Órganos , Ratas , Ratas Sprague-Dawley , Absorción Cutánea/fisiología
4.
J Pharm Pharmacol ; 65(8): 1195-203, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23837587

RESUMEN

OBJECTIVES: This study aimed to evaluate the effects of torsemide on warfarin therapy in humans and rats. METHODS: For the animal study, rats were orally dosed with warfarin (0.13 mg/kg, control group) or warfarin (0.13 mg/kg) with torsemide (2 mg/kg, low dose group and 10 mg/kg, high dose group). The pharmacodynamic response of warfarin was assessed by measuring the international normalized ratio (INR) for 5 consecutive days following drug administration. For the human study, 191 patients on warfarin with mechanical heart valves were followed up retrospectively. The stable dose was calculated as the mean dose in INR levels of 2-3 for 3 consecutive times. KEY FINDINGS: In the animal study, the INR, maximum plasma concentration (Cmax ) and area under the plasma drug concentration-time curve (AUC0-∞ ) of (S)-warfarin in the high dose group were significantly higher than in other groups (P < 0.05). Compared with the control group, Cmax and AUC0-∞ of (R)-warfarin in the high and low dose groups were higher, whereas the volume of distribution/bioavailability and clearance/bioavailability were significantly lower (P < 0.05). In the univariate analysis of the clinical study, diuretics significantly lowered stable warfarin doses (P = 0.016) (5.07 ± 1.78 mg/day vs 5.77 ± 1.81 mg/day). After controlling confounding variables, the effects of diuretics were found to lower the warfarin dose by 0.464 mg. CONCLUSIONS: It was concluded that warfarin dose needs to be lowered when it is used concomitantly with diuretics.


Asunto(s)
Anticoagulantes/farmacología , Anticoagulantes/farmacocinética , Diuréticos/farmacología , Sulfonamidas/farmacología , Warfarina/farmacología , Warfarina/farmacocinética , Animales , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Hidrocarburo de Aril Hidroxilasas/genética , Citocromo P-450 CYP2C9 , Sistema Enzimático del Citocromo P-450/genética , Familia 4 del Citocromo P450 , Diuréticos/administración & dosificación , Diuréticos/uso terapéutico , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Femenino , Humanos , Relación Normalizada Internacional , Masculino , Persona de Mediana Edad , Análisis Multivariante , Polimorfismo de Nucleótido Simple , Ratas , Ratas Sprague-Dawley , Sulfonamidas/administración & dosificación , Sulfonamidas/uso terapéutico , Torasemida , Vitamina K Epóxido Reductasas/genética , Warfarina/administración & dosificación , Warfarina/uso terapéutico
5.
Int J Cardiol ; 145(2): 275-276, 2010 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-19913311

RESUMEN

BACKGROUND: The objective of this study was to determine whether an interaction exists between warfarin and Korean red ginseng. METHODS: A prospective, double-blind, randomized, two-period crossover study was conducted on 25 patients with cardiac valve replacement under warfarin therapy. Either Korean red ginseng 1 g or placebo (hop extract 0.25 g, caramel color 0.05 g, and red ginseng flavor 0.03 g) was concomitantly administered with warfarin. INR and warfarin concentrations were analyzed on the 3rd and 6th weeks of each study period. RESULTS: The INR changes on the 3rd and 6th weeks of Korean red ginseng administration were -0.16±0.95 and -0.14±0.94 whereas those of placebo were -0.03±0.65 and 0.25±0.95; there were no statistically significant differences in mean INR changes. CONCLUSION: Korean red ginseng could be used with close monitoring and under appropriate education in patients who take warfarin.


Asunto(s)
Implantación de Prótesis de Válvulas Cardíacas , Interacciones de Hierba-Droga/fisiología , Panax/metabolismo , Extractos Vegetales/sangre , Warfarina/sangre , Estudios Cruzados , Método Doble Ciego , Femenino , Prótesis Valvulares Cardíacas , Humanos , Relación Normalizada Internacional , Masculino , Persona de Mediana Edad , Extractos Vegetales/uso terapéutico , Estudios Prospectivos , Warfarina/uso terapéutico
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